Should grieving be considered a psychiatric disorder? How do you define grief? How do you counsel or minister to those who are grieving? Can/should grief be medicated?

Grief should not be considered a psychiatric disorder, but a normal reaction to loss in one’s life. Everyone experiences grief. I experienced it last fall when my Mother died. I felt most comforted by knowing that the church was present to me, praying for me and reaching out to me. Here I don’t mean just the people of St. Peter, although they were wonderfully present, but all God’s people of different faiths and traditions. Grief support groups are often very helpful. Time is also necessary for healing.

When Mother died, someone who had also just lost a loved one said to me, “How do people without faith get through these times?” I responded by saying, “I don’t know. But aren’t you glad we have our faith to see us through?”

Should grieving be considered a psychiatric disorder? How do you define grief? How do you counsel or minister to those who are grieving? Can/should grief be medicated?

Psychiatric disorder or not, grieving is a human condition. The death of a parent is commonplace – 12 million Americans bury a parent every year. Yet the grief that accompanies losing someone close is anything but ordinary. The world is a different place after a loved one’s death, just as the world has been forever changed because of a loved one’s life. Grieving is so complex. It traps and shakes our emotions. I understand the need for medication at times but feel that grief work has found resolution when it leads us back to becoming and to doing whatever it is that we do best.

Should grieving be considered a psychiatric disorder? How do you define grief? How do you counsel or minister to those who are grieving? Can/should grief be medicated?

One person’s approach to grief: When her husband died, friends told her she would need to go through the various stages of grief, including anger and depression. Someone else advised her to fill each day with “joy, activity and gratitude.” As a daily reminder, she wrote a word on her refrigerator from the initials–”JAG”–and then followed the advice. She thought often of her husband with appreciation, but never grieved or suffered from anger or depression. She passed on the advice to others, who found it to be a great help.

Grief is an essential part of the human experience, and is one of the great levelers of us all, regardless of socio-economic level, race, culture or religion.  It is normal to feel pain, confusion, loneliness, being lost and having life disrupted during a loss.  There is also no one way to grieve; our responses to grief are as varied and complex as humanity itself. As such, it does not occur in nice, neat stages as defined by Elizabeth Kubler-Ross. There is often guilt associated with grief, and it seems to help those whom I counsel to realize that each person has to work out his or her own healthy way to deal with loss.

Thus, I think it is vital for the person experiencing the loss to feel the love and support of others. Without this (or sometimes even with this) the person can get stuck. There is a need to find meaning, and often to relocate the person lost from the external world to the internal world or in one’s heart. This happens best in a community of trust, be it a faith community, a group of friends, or other family members….or best yet…all three.

Is medication ever necessary? For the reasons stated above, grief in and of itself need not be medicated. However, the anxiety that sometimes surrounds a grieving person might need short-term medication in order for the person to function. And when grief turns to suicidal thoughts, substance abuse, physical issues, or ongoing debilitating guilt, it is advisable to seek the help of a professional.

In my own Christian tradition, it is helpful to realize that Jesus himself grieved. He wept over the loss of his friend Lazarus. He grieved…and wept…over the city because “they did not know the things that make for peace.” By his example, we can see the truth of the title of Wesley Granger’s classic book: ”Good Grief.”

Should grieving be considered a psychiatric disorder? How do you define grief? How do you counsel or minister to those who are grieving? Can/should grief be medicated?

New or expanded medical (or psychiatric) conditions are often more about money than proper diagnosis and treatment.

For example, the attribute long known as “shyness” has been medicalized into the diagnosis “social anxiety disorder.” When a condition like shyness gets an official designation in psychiatry’s Diagnostic and Statistical Manual (DSM), it becomes a source of income for pharmaceutical companies who subsequently spend millions directly advertising to Americans. “Do you get nervous around people..? Are you ever anxious or unsettled in public..? You may have social anxiety disorder.” Those same companies create informational websites and finance what appear to be grass-roots support groups that further hammer home the message: you’re sick and should ask your doctor to put you on our medicine.

This market-creating behavior is disturbing enough when it targets adults, but there’s been an unconscionable (and successful) effort to push medications on children for similar trumped-up diagnoses. Boys, especially, are prescribed drugs to “treat” behaviors that a generation ago would have been understood as normal. Everybody wins: drug companies profit, physicians and psychologists have more patients, teachers enjoy serene students, and parents are relieved that they’re not responsible for their children’s bad behavior.

The only losers are the kids–and the US economy that has to absorb the unrestrained costs associated with each new or expanded diagnosis.

Should grieving be considered a psychiatric disorder? How do you define grief? How do you counsel or minister to those who are grieving? Can/should grief be medicated?

The current APA definition of depression is suitable in my opinion. I’m a pastor not a clinician, so I don’t diagnose depression or disorders or prescribe medications. I’m careful not to breezily suggest depression in pastoral counseling. If I suspect it in the counselee I refer him to a couple of counseling centers I trust and recommend he also consult with his physician. In some cases I can monitor his progress with a professional therapist if needed.

My counseling conversations with the grieving are usually considerations of God’s involvement in their pain. Because our faith has a cross in its center I know God is not aloof but has immersed Himself in human suffering, both identifiably (He empathizes) and triumphantly (He conquers). Sometimes those in grief are seeking reassurance of God’s control over their lives. Sometimes they’re wondering if they’ve been forgotten by God or are being punished. Sometimes they want to gauge the normalcy of their feelings and/or doubts. I mostly use the laments of David and the cross of Jesus in counseling people in my church through grief.

Some levels of incapacitating grief may require a season of therapy, but can’t grief be therapeutic in itself? People need to grieve their losses. It’s usually healthier for us when we do. I’d hate for us to have this compounded by worries over whether or at what point our grieving is disorder.

I’m probably more concerned for those over-reserved in bereavement than those overcome by bereavement. I’ve encountered people who seem to believe that intense or sustained expressions of grief are inappropriate for those with a hope of Heaven. Sometimes I find myself giving people permission to grieve, freeing them from suppressing it. God made us with capacity for grief too. The things that cause us grief are evidence of disorders in this world. When we run up against them or are run over by them, it seems to me grieving is more in order than inordinate.